Published online October 31, 2008
PEDIATRICS Vol. 122 Supplement November 2008, pp. S130-S133 (doi:10.1542/peds.2008-1055e)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kennedy, R. M.
Right arrow Articles by Zempsky, W. T.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Kennedy, R. M.
Right arrow Articles by Zempsky, W. T.
Related Collections
Right arrow Office Practice
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

SUPPLEMENT ARTICLE


Clinical Implications of Unmanaged Needle-Insertion Pain and Distress in Children

Robert M. Kennedy, MDa, Janet Luhmann, MDa and William T. Zempsky, MDb,c

a Department of Pediatrics/Division of Emergency Medicine, Washington University in St Louis School of Medicine, St Louis, Missouri
b Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut
c Pain Relief Program, Connecticut Children's Medical Center, Hartford, Connecticut

Increasing evidence has demonstrated that pain from venipuncture and intravenous cannulation is an important source of pediatric pain and has a lasting impact. Ascending sensory neural pain pathways are functioning in preterm and term infants, yet descending inhibitory pathways seem to mature postnatally. Consequently, infants may experience pain from the same stimulus more intensely than older children. In addition, painful perinatal procedures such as heel lancing or circumcision have been found to correlate with stronger negative responses to venipuncture and intramuscular vaccinations weeks to months later. Similarly, older children have reported greater pain during follow-up cancer-related procedures if the pain of the initial procedure was poorly controlled, despite improved analgesia during the subsequent procedures. Fortunately, both pharmacologic and nonpharmacologic techniques have been found to reduce children's acute pain and distress and subsequent negative behaviors during venipuncture and intravenous catheter insertion. This review summarizes the evidence for the importance of managing pediatric procedural pain and methods for reducing venous access pain.

Key Words: venipuncture • peripheral cannulation • pain • nociceptors • psychophysiology • developmental biology

Abbreviations: IV—intravenous • ED—emergency department

Accepted Jun 4, 2008.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 PediatricsHome page
W. T. Zempsky
Optimizing the Management of Peripheral Venous Access Pain in Children: Evidence, Impact, and Implementation
Pediatrics, November 1, 2008; 122(Supplement_3): S121 - S124.
[Full Text] [PDF]